[Fast-track rehabilitation for acute cholecystitis: intermediate outcomes of prospective randomized trial].

Autor:	Sazhin AV; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Pirogov City Clinical Hospital #1, Moscow, Russia., Nechay TV; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Pirogov City Clinical Hospital #1, Moscow, Russia., Titkova SM; Depatment of experimental surgery research institute of translational medicine Pirogov Russian National Research Medical University, Moscow, Russia., Anurov MV; Depatment of experimental surgery research institute of translational medicine Pirogov Russian National Research Medical University, Moscow, Russia., Tyagunov AE; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia., Balakirev YS; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Pirogov City Clinical Hospital #1, Moscow, Russia., Ermakov IV; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Bauman City Clinical Hospital #29, Moscow, Russia., Tyagunov AA; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Pirogov City Clinical Hospital #1, Moscow, Russia., Melnikov-Makarchuk KY; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Bauman City Clinical Hospital #29, Moscow, Russia., Glagolev NS; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Bauman City Clinical Hospital #29, Moscow, Russia., Mirzoyan AT; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Bauman City Clinical Hospital #29, Moscow, Russia., Kurashinova LS; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Bauman City Clinical Hospital #29, Moscow, Russia., Kolygin AV; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Bauman City Clinical Hospital #29, Moscow, Russia., Nechay VS; Tul'skaya Region Clinical Hospital, Tula, Russia., Ivanova EA; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia., Ivakhov GB; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia; Pirogov City Clinical Hospital #1, Moscow, Russia., Mosin SV; Chair of Faculty-Based Surgery #1 of the Faculty of Medicine Pirogov Russian National Research Medical University, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2018 (12), pp. 13-20.
DOI:	10.17116/hirurgia201812113
Abstrakt:	Aim: To analyze an efficacy of FT-protocol in patients with acute cholecystitis. Material and Methods: Prospective randomized study included 102 patients (45 of main group (FT) and 57 of control groups). Patients did not differ by TG13 severity index. The protocol included information, antibiotic prophylaxis, restriction of drainage, intraperitoneal anesthesia with long-term anesthetics, low pressure pneumoperitoneum, antiemetics in the presence of risk factors, early activation and feeding of the patient. Pain was assessed by VAS immediately after surgery, and 2, 6 and 12-24 hours postoperatively. Results: Surgery time was similar in both groups. Need for anesthesia and pain severity were significantly lower in the FT group. A total absence of pain (VAS 0-1) on the 1 st postoperative day was noted in 8 (17.7%) of the FT group and 2 (3.5%) patients of the control group (p=0.038). Shoulder pain developed in 4 (8.9%) cases of the main and 22 (38.6%) cases of the control group (p=0.001). Postoperative nausea developed in 13% of the FT group vs 40.5% in the control group (p=0.05). Hospital-stay was 1.29±0.7 days and 2.7±1.6 (p<0.0001), respectively. The time of the first stool was similar. Twenty-four (53.5%) patients of the FT group and 8,9% of the control group were discharged on 1 st postoperative day. There were 2 (IIIA) complications in the main group and 3 - in the control group (IIIA, IIIB and IV). There were no mortality and readmissions. Conclusion: FT protocol in AC reduce postoperative pain, dyspepsia, shoulder pain and in-hospital stay with equal number of postoperative complications.
Databáze:	MEDLINE
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